| In developed as well as developing countries, there are grave concerns about the reproductive health of women. Maternal and infant mortality and morbidity are directly linked to a woman's reproductive health and are primary areas of public health concern (Howson, et al., 1996). To improve the reproductive health of women, healthcare professionals and researchers seek to identify the root problems so that strategies can be employed to predict, prevent, treat and cure the problems.;In developing countries the components of reproductive health, which are most frequently researched, include family planning, maternal and infant hygiene and nutrition, and the prevention of sexually transmitted diseases and other diseases, which can impact women during their childbearing years. The key to addressing these concerns lies with women's access to quality healthcare and health education throughout the life cycle (Howson et al., 1996). A woman's access to information, social support and health care during early adolescence and the childbearing years has a significant impact on her lifetime health experience. Historically, a major source of reproductive health care and information has come from midwives (lay, certified and nurse practitioner) (Sargent and Bascope, 1996). However, the lay midwife has had limited opportunities to identify the various factors that impact the manner in which she provides care.;This study utilizes historical materialism and feminist theory to identify from the perspective of the lay midwife the social, economic, and political factors that impacted the manner in which Jamaican and African American lay midwives provided care during the twentieth century. In addition to identifying the factors that impact the manner in which care is provided, the model of care utilized by the midwives in the two countries is explored. Finally, a comparative analysis of the Jamaican and United States lay midwifery models of care is conducted.;This exploratory research project uses a concurrent transformative mixed methods approach, which includes the collection and analysis of a combination of both primary and secondary data, qualitative and quantitative respectively. The data reveals that social policies, economic forces and social movements of the early and middle 1900s have had a synergistic impact whose result was a diminishing of the value of the midwifery model of care and created a sense of societal marginalization among the lay midwives in both countries. In spite of the marginality of this health care provider, lay midwives feel that their practices have continued to positively, contribute to the health of their communities, and though significantly diminished in quantity, have not completely disappeared but continue to evolve via improved quality of care. |
